Kampman et al., 2015


To observe the incidence of cardiovascular

complications in the first year postpartum and to compare cardiac function parameters pre-pregnancy and

1-year postpartum in women with CHD.

172 pregnancies in 172 women

8 participating centers, the Netherlands

A prospective multicenter cohort study

Cardiovascular events 1-year postpartum:

Women with higher modified WHO risk classifications before pregnancy had higher cardiovascular events. Of the women with cardiovascular events postpartum, 63.6% had no history of cardiovascular events before pregnancy and 71.4% developed new arrhythmia.

Women with cardiovascular events during pregnancy had a higher risk of cardiovascular events postpartum compared with women without cardiovascular events during pregnancy. The incidence of cardiovascular events 1-year postpartum was 6.4%.

Pillutla et al., 2016


To identify the cardiovascular and neonatal outcomes in pregnant women with high-risk CHD.

61 pregnancies in 43 women

The Ahmanson/ University of California Los Angeles (UCLA) Adult Congenital Heart Disease Center (ACHDC), USA

Single-center retrospective analysis

Of all pregnancies, 31% were complicated by a cardiovascular event and that the most common cardiac events were either heart failure or arrhythmias.

Development of any major cardiac complication during pregnancy was best predicted by antepartum maternal arrhythmia.

Bowater et al., 2013


To examined whether the deterioration associated with pregnancy is due to the physiological changes of pregnancy itself, or is part of the known deterioration that occurs with time in these patients.

31 pregnancies in 18 women

Queen Elizabeth Hospital, UK

Retrospective analysis

This study suggests that pregnancy is associated with a premature deterioration in RV function in women with a systemic RV. These women are also more symptomatic, with a greater reduction in functional class compared with patients with a systemic RV who do not undergo pregnancy.

There are increased risks in comparison with the general population, with a higher preterm delivery and low birth weight rates. There is also a higher cesarean section rate in this population, 39% vs. a 23% average for the hospital.

Assenza et al., 2013


To better understand the quantitative volumetric changes associated with pregnancy in women with repaired tetralogy of Fallot (TOF), utilizing sequential cardiovascular magnetic resonance (CMR) imaging.

30 pregnancies in 30 women, and 26 nulliparous women (Total 56)

Boston Children’s Hospital, USA

Retrospective analysis of records

Women with repaired TOF who have completed pregnancy appear to experience an accelerated rate of right ventricular remodeling, defined as an increase in end-diastolic volume; however RV systolic function does not deteriorate.

Ladouceur et al., 2016


To describe maternal and fetal outcomes during pregnancy in patients with PAH-CHD.

28 pregnancies in 20 women

Seven different French centers, France

Retrospective multi-center analysis

28 pregnancies in 20 women (26 ± 6 years old) with PAH-CHD were managed during this period. There were 18 complete pregnancies (≥20 weeks’ gestation (WG)), 8 abortions and 2 miscarriages. Six (33%) patients experienced severe cardiac events they had lower resting oxygen saturation. The most common cardiac complications during the complete pregnancies were heart failure (n = 4) and severe hypoxemia (n = 5). Heart failure was overall severe, requiring inotropic treatment in three patients, mechanical circulatory support in one and led to one maternal death (mortality = 5.0%). Obstetrical complications occurred in 25% of pregnancies. Small for gestational age was diagnosed in 39% (7/18) of fetuses. 12/18 (67%) pregnancies were delivered by caesarean section, of which 10 in emergency for obstetrical reason. Prematurity was frequent (78%), but no neonatal death occurred.